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Inspection on 27/07/06 for Beechcroft House, Midsomer Norton

Also see our care home review for Beechcroft House, Midsomer Norton for more information

This inspection was carried out on 27th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Beechcroft provides a "small family" environment with a stable and committed staff group who have a good understanding of individuals who live in the home. One residents spoke of how they liked "the smallness of the place, homely and lived in atmosphere" and another "can`t fault it, homely, just like home from home". There is good practice in care planning with care plans that identify clearly the health and social care needs of residents.

What has improved since the last inspection?

Requirements made form the previous inspection about reviewing of care plans and POVA training have been met leading to continued improvement in care planning practice and ensuring that staff have received the necessary training to protect residents from abuse.

What the care home could do better:

Only one area was identified from this inspection which needs to be addressed that of completing risk assessments for those individuals who manage theirown medication. This is to confirm that individuals are able to do so in a safe way and any risks are identified. There remain a number of staff who have not completed POVA training and this needs to be considered as a mandatory area of training.

CARE HOMES FOR OLDER PEOPLE Beechcroft House 75 North Road Midsomer Norton Bath & N E Somerset BA3 2QE Lead Inspector Jon Clarke Key Unannounced Inspection 27th July 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Beechcroft House DS0000008148.V304096.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Beechcroft House DS0000008148.V304096.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beechcroft House Address 75 North Road Midsomer Norton Bath & N E Somerset BA3 2QE Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01761 419531 01761 419531 Mrs Sarah Louise Thomas Mrs Sarah Louise Thomas Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (14) of places Beechcroft House DS0000008148.V304096.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 14 persons aged 65 years and over requiring personal care only. 11th October 2005 Date of last inspection Brief Description of the Service: Beechcroft is a small family run care home for 14 older people established by the current owner 15 years ago and situated in the town of Midsomer Norton. The home is an extended and converted detached house. Accommodation is provided in single rooms over two floors with stair lift access to the first floor. All rooms other then 3 have en-suite facilities the remaining three have washbasins; there are bathrooms as well as shower facilities. There are two lounges one of which includes a dining area in addition there is a conservatory with level access to the garden. Beechcroft aims to provide its residents with a secure, relaxed and homely environment in which their care, well being and comfort are of prime importance. we pride ourselves on offering a highly professional care service, with a personal touch. (From the homes Statement of Purpose) Beechcroft also offers day care by arrangement. The homes Mission Statement states Beechcroft Residential home strives to provide consistent high standard of care at all times. To do this we try hard to: Understand our clients needs, Promote the best care values and Train and motivate our staff. Beechcroft House DS0000008148.V304096.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day. As part of the inspection a number of records were looked at including care plans, daily records, training and those relating to health & safety practice in the home. There was also an opportunity to discuss with residents and staff their experience of living and working in the home. What the service does well: What has improved since the last inspection? What they could do better: Only one area was identified from this inspection which needs to be addressed that of completing risk assessments for those individuals who manage their Beechcroft House DS0000008148.V304096.R01.S.doc Version 5.2 Page 6 own medication. This is to confirm that individuals are able to do so in a safe way and any risks are identified. There remain a number of staff who have not completed POVA training and this needs to be considered as a mandatory area of training. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Beechcroft House DS0000008148.V304096.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Beechcroft House DS0000008148.V304096.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The quality rating in this outcome group is good. This judgement has been made using available evidence including a visit to the service. Assessments are undertaken of prospective residents health and social care needs so that an informed decision can be made as to the capacity of the home to meet identified needs. EVIDENCE: A number of pre-admission assessments were seen showing good information about care needs, daily routines of perspective residents. Where individuals are assessed by the local authority copies of assessments are obtained. Where there are mental health difficulties the home will involve the mental health team to make sure the home can manage the individual and the home is suitable for the individual. Beechcroft House DS0000008148.V304096.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 The quality rating for this outcome group is good. This judgement has been made using available evidence including a visit to the service. The care planning practice of the home helps to make sure that staff have the necessary information to meet health and social care needs. The arrangements for meeting health needs are good. Arrangements for the management of residents medication is generally good which helps to make sure that the health of residents is safeguarded. EVIDENCE: A number of care plans were looked at and they illustrated good practice with information about the daily routines of residents, the abilities of residents in relation to daily tasks such as dressing and undressing and what help was needed. Risk assessments are completed and importantly reviewed to make sure that the information is accurate and reflects the actual needs of residents. Moving and handling assessments provided staff with guidance about safe Beechcroft House DS0000008148.V304096.R01.S.doc Version 5.2 Page 10 practice when assisting residents with their mobility. Resident’s signature on care plans showed their involvement in completing care plans and when speaking to residents they confirmed that they had discussed with staff what help they needed. The home completes Risk Assessment for Falls which assists in identifying potential risks for residents this had been completed for an individual who has a history of falls. There is good access to community health services such as chiropody (every 8 weeks) dental and optician services are arranged either through visits to the home or using local service. Where individuals require medical support referrals are made to the district nursing service. Medication records were looked at and showed accurate recording of medication administer to residents. The storage provided was good and included additional secure storage for controlled drugs. The home has two residents who have responsibility for their medication however no risk assessment had been completed. Residents spoke of the flexibility of the home; “it is up to me when I get up”, “I can choose what I want to do and when” “don’t think there are restrictions here”. When asked about how staff treat them residents said: “always treat me well” “as I would want to be you can’t ask for better” One resident when asked whether they felt their privacy was respected replied “ I never feel staff intrude”. Staff were observed speaking to residents in an appropriate way and with sensitivity particularly when assisting residents and responding to a resident who was agitated and confused. Beechcroft House DS0000008148.V304096.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 The quality rating for this outcome group is good. This judgement has been made using available evidence including a visit to the service. The home makes a good effort to meet the social and religious needs of residents. Arrangements for maintaining contact with important people in the lives of residents are good and there is a welcoming environment in the home. Residents are provided with a balanced diet and the meals are wholesome and varied. EVIDENCE: Residents when asked about the activities available in the home said that they felt there “was enough” as important is the interaction between residents and staff. Residents spoke of the “friendliness” of staff and how “they always have time for you”. The home has arranged for an occupational therapist to visit the home on a weekly basis providing various activities including exercise, bingo. A member of staff has also been identified to provide regular activities. There is a weekly religious service in the home. The home recognises the importance of residents maintaining contact with family and friend and residents spoke of how “welcoming” the home is to visitors. A relative who was visiting the home at the time of this inspection spoke of the “friendly and helpful staff always welcoming” Beechcroft House DS0000008148.V304096.R01.S.doc Version 5.2 Page 12 Residents were very positive about the varied meals provided “always good “ was a common response when asked about food in the home. Menus were seen which showed variety and good choice. There is a real effort to provide homely meals. One resident spoke of the food as being “excellent” and how “staff will always find something else for me if I don’t like what’s on” another said that the staff “know what I like”. The home will also cater for any specialist diets. On the day of the inspection the lunchtime meal was well presented and appetising. When residents were asked about the routines and flexibility of the home and whether they felt restricted in how they spent their day there were a number of individuals who felt there were “no real restrictions here” “we can do pretty much as we like” “I choose what I do and how I spend my day” “come and go as you like” were the common responses. Beechcroft House DS0000008148.V304096.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The quality rating in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home’s practice and procedures help to make sure that residents and others are able to make any complaint or dissatisfaction and their views will be listened and necessary action will be taken. Residents are protected as far as possible from abuse by the home procedures and training. EVIDENCE: There is a complaints procedure in place and residents when asked were aware of their right to register any complaint or voice concerns. The pre-inspection questionnaire asked if residents knew how to make a complaint or who to speak to if they were unhappy all of the respondents said yes. Importantly when speaking to residents they were very positive about how if they did feel unhappy about anything “I can always speak to a member of staff” “they always do something” “I only have to say and staff will try and make it better for me” “I never feel I cant say how I feel”. There was a real sense when speaking to residents that their wishes and views would not only be listened to but also respected. The home has procedures in place providing guidelines and instructions about how to response to any allegation of abuse. Staff have completed Adult protection training, which provides them with a knowledge and understanding of the nature of abuse particularly in a care home setting. Beechcroft House DS0000008148.V304096.R01.S.doc Version 5.2 Page 14 Beechcroft House DS0000008148.V304096.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 The quality rating in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The practices of the home help to provide a safe, clean, hygienic and wellmaintained environment. EVIDENCE: In looking around the home it was evident that there is a good standard of cleanliness. This was confirmed by residents who spoke of the home as “always clean and well kept” “they (staff) always make sure the home is clean”. A visitor to the home said that the home was “always clean and tidy”. There are procedure in place which instruct staff on standards of hygiene and where necessary staff have completed Infection Control training. At the time of this inspection the home was clean and free from offensive odours. Beechcroft House DS0000008148.V304096.R01.S.doc Version 5.2 Page 16 Beechcroft House DS0000008148.V304096.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,29,30 The quality rating in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The staffing arrangements in the home ensure that there are adequate staff available to meet the care needs of resident and that staff are trained to provide care in a competent and professional way. The recruitment practice of the home helps to make sure the welfare of residents is protected and necessary checks and safeguards are undertaken. EVIDENCE: There are generally 2 staff on duty am, 2 pm and waking night staff in addition to housekeeper. When taken against the care needs of residents this is adequate staffing. Recruitment record for a recently recruited member of staff was looked at and showed that the necessary checks had been completed namely CRB and POVA, 2 references had been obtained and the application form gave full and detailed information about the employee. This staff member had completed an induction period and necessary training. The training records of all night staff (4) were looked at and showed that mandatory areas of training had been completed: moving and handling, fire, first aid, and food hygiene. One had also completed Certificate Occupational Health & Safety. Only one of these members of staff had completed POVA training. Staff have attended Parkinson’s Study Day, training organised by Beechcroft House DS0000008148.V304096.R01.S.doc Version 5.2 Page 18 Dorothy House: Communicating with people in distress. A number of staff have completed NVQ 2 or 3 training. In talking with residents about how they saw staff one commented that they felt “confident” about the ability of staff. Beechcroft House DS0000008148.V304096.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33,35,38 The quality rating in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The manager of the home ensures that there are opportunities for residents to express their views and that the health, safety and welfare of residents and staff is protected. EVIDENCE: Residents spoke of being “able to say what I think” “if I have a problem only have to speak to staff” A number were very positive about the manager and deputy being “approachable” “I can always go to them if I don’t like something or am bothered by something”. Resident’s questionnaire had been undertaken in April 06 this provided positive feedback about the quality of care provided in the home.. A questionnaire completed by a visiting professional to the home Beechcroft House DS0000008148.V304096.R01.S.doc Version 5.2 Page 20 stated that they were “always asked for advice whenever necessary” “staff always helpful”. It is the practice of the home not to hold money for residents and residents if able manage their own financial affairs or are assisted by a relative or their representative. Services received by residents such as chiropody are invoiced to residents. Health and Safety records were looked at and showed that the necessary fire and safety checks are undertaken. There is yearly maintenance of equipment in the home; Gas Safety certificate issued 13/04/06. The home has also completed risk assessments in relation to the environment and security of the home including a fire risk assessment. Beechcroft House DS0000008148.V304096.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 x 3 X X 3 Beechcroft House DS0000008148.V304096.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13 (4c) Requirement Ensure where residents manage their own medication a risk assessment is completed and reviewed on a regular basis. Timescale for action 27/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Beechcroft House DS0000008148.V304096.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Beechcroft House DS0000008148.V304096.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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